Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $16.98	Facility	26	$14.13	$14.13	$16.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $275.42	Professional		$75.86	$102.33	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.30 / $54.95	Professional	26	$10.00	$12.30	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $89.13 / $218.78	Professional	TC	$63.10	$89.13	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $8.91 / $9.12	Professional	26	$8.91	$8.91	$9.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $181.97	Professional		$75.86	$102.33	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.48 / $19.95	Professional	26	$11.22	$11.48	$19.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $162.18	Professional	TC	$66.07	$91.20	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $158.49 / $245.47	Professional		$89.13	$158.49	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.49 / $20.42	Professional	26	$8.91	$13.49	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $134.90 / $213.80	Professional	TC	$77.62	$134.90	$213.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.98 / $117.49 / $162.18	Professional		$0.98	$117.49	$162.18
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $13.49 / $18.20	Professional	26	$0.13	$13.49	$18.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $104.71 / $141.25	Professional	TC	$45.71	$104.71	$141.25
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.98 / $0.98 / $147.91	Professional		$0.98	$0.98	$147.91
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $0.13 / $16.98	Professional	26	$0.13	$0.13	$16.98
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $75.86 / $131.83	Professional	TC	$75.86	$75.86	$131.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.22 / $11.22	Professional	26	$11.22	$11.22	$11.22
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $87.10 / $87.10	Professional	TC	$85.11	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $204.17	Professional		$89.13	$120.23	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.72 / $20.42	Professional	26	$8.71	$10.72	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $112.20 / $190.55	Professional	TC	$83.18	$112.20	$190.55